Plan for the New Division of Clinical Informatics and Digital Transformation (DoC-IT) in the UCSF Department of Medicine

Health care’s digital revolution is gaining steam, as evidenced by enormous growth in funding for digital companies (both start-ups and digital giants such as Google, Amazon, Microsoft, and Apple), the surge in telemedicine and virtual care, increased interest in digital transformation by health systems, trainees, and faculty, and more. UCSF has many important people, programs, centers in the digital space – such as BCHSI, CDHI, CTSI, Computational Precision Health, Epi/Biostat, SOLVE, and informatics-oriented groups and faculty in many departments. But there is no central academic hub for faculty interested in the clinical aspects of digital transformation and applied informatics research – ranging from app development to data science to clinical decision support to changing the care delivery system using digital tools. 

While interest and talent in digital medicine is spread throughout the SOM (and other schools), as the largest department the Department of Medicine (DOM) has the most faculty and trainees interested in this space. Currently, our approach to Clinical Informatics and Digital Transformation is fragmented, with all DOM faculty whose work is in this space having their primary appointment in an existing division. For clinicians, this is generally a division defined by their clinical specialty, which – for a faculty member whose primary professional focus is informatics research or operations – may create a lack of connection with the informatics community. There are additional challenges for informatics-oriented PhDs, since their work is often less disease- and specialty-specific, yet they are forced to choose a single clinically oriented division as their home. 

In addition, the absence of a divisional home for informatics leaves the DOM without a logical home for core digital assets (including the clinical informatics fellowship and data science consultative programs), nor a structure and resources to promote research, education, community building, and recruitment – not only within the DOM but in collaboration with other departments and units. 

The new Division of Clinical Informatics and Digital Transformation (DoC-IT) will serve as the primary home for selected DOM faculty whose main professional focus is Clinical Informatics and Digital Transformation. We expect most of the PhDs whose work is not specialty-specific to move their primary appointment to the new division; many will maintain a secondary appointment in a clinical division in which they frequently collaborate. For physician-faculty who continue to practice in a specialty but whose primary (>60-80%) professional focus is on research, education, or operational work in informatics and related fields, the new division can be a primary home (if that is the preference of the faculty member) or a secondary home. In the latter case, our aim is that the division will also serve as a center to facilitate collaboration and education, as well as a repository for expertise and tools relevant to these faculty.

Divisional Mission and Strategies

To enhance the quality, safety, patient and provider experience, and equity – and lower the cost – of healthcare by becoming the preeminent academic unit focused on clinical informatics and digital transformation. We will do this by:

  • Being a highly productive research unit studying the use of digital data, tools, and workflows to improve health and healthcare
  • Enhancing UCSF’s digitally-related educational enterprise by providing content and programs for the UCSF community (students, residents, fellows, faculty) and, where appropriate, to the broader outside community
  • Partnering with our health systems, as well as the digital ecosystem of the Bay Area and beyond, to improve health and healthcare by integrating the latest research and innovative thinking into our digital and related systems
  • Advancing health policy as it relates to the digital transformation of the healthcare system

Who Will Be in the Division and What Will It Do?

At its launch, we envision that the division will include about 15-20 faculty members with primary appointments – likely about half PhDs and half MDs whose primary focus is in various aspects of clinical informatics and applied research. In addition, we believe 25-50 additional faculty members throughout UCSF will choose to have secondary appointments in DOC-IT. 

In addition to facilitating the research, educational, and operational efforts of its members, the division will include certain assets and capabilities that will enhance its standing and visibility. These will include:

  • Bringing together diverse digital communities on campus for conferences and works-in-progress
  • Communicating to the UCSF community and beyond about UCSF’s clinical informatics activities
  • Advocating for the campus structures to facilitate the work of its members
  • Housing many key educational programs in clinical informatics, including (but not limited to) the Clinical Informatics fellowship
  • Housing some core digital programs (including mechanisms to access digital data or other kinds of consultative assistance) of general use to the DOM community (and potentially broader UCSF community)

Of note, the division’s perspective will be primarily clinical. Other units on campus, such as BCHSI, focus more on bioinformatics (genomics, precision medicine, basic research). We envision important collaborations between DoC-IT and theses entities (such as how to integrate precision medicine insights into day-to-day clinical practice), but the main focus will be on improving healthcare value (quality, experience, efficiency, and ultimately health outcomes).

Proposed Plan

  • New Division to launch in academic year 2023-24
  • Initial faculty: 
    • All PhDs whose work centers on clinical informatics and digital transformation will be offered primary appointments (after consultation with current division chiefs)
    • All MDs whose work centers on clinical, research, policy, and education in clinical informatics (>60-80% time) will be offered primary or secondary appointments, in consultation with their current division chiefs
    • The division will also consider secondary appointments for relevant faculty in other departments or schools (such as SON or SOP)
  • The division will be physically based at UCSF Health (in dedicated space in the Koret Building), and much of its operational and research focus will be built in collaboration with UCSF Health informatics programs. It will also have a presence at the other sites (ZSFG, VA), with relevant faculty offered primary or secondary appointments, as appropriate.
  • Resources
    • TBD, but sufficient to recruit a world-class leader, recruit several new faculty in the next 5 years, and build and grow the infrastructure and community to support informatics-related academic programs and people throughout the DOM. While we expect a significant DOM investment in the new division, we will also be working hard to secure philanthropic support.

Search

We will launch a national search for a world-class leader of this division in September 2022, with a goal of identifying the leader by early 2023 who can launch the division in academic year 2023-24.